Brain Diseases and Disorders

21

they may have difficulties in daily life activities. The fact that one’s intel-

ligence and knowledge are preserved and cannot be used to regulate their

thoughts and behaviors is called the “frontal lobe paradox” [153]. In addi-

tion to the classical tests in neuropsychological evaluation, it is important to

measure the skills of the person in daily life activities that require cognitive

ability, in creating a more accurate neuropsychological evaluation profile. Un-

fortunately, there are no psychotropics specially developed for the treatment

of psychiatric diseases. Although the symptom profiles of the diseases differ

from the primary psychiatric disorders, there is still an obligation to treat the

indications with drugs that are the primary psychiatric diseases [151].

1.8.1

Schizophrenia (SCZ)

Schizophrenia (SCZ) is a mental disorder characterized by symptoms such as

delusions, hallucinations, behavioral and speech disorders, and lack of emo-

tion, distorting one’s thoughts, actions, expression of emotions, and percep-

tion of reality [154]. It is a heterogeneous disorder associated with metabolic

changes, hormonal regulation, and immune status [155]. Subtypes of SCZ,

which were included in the psychiatric diagnosis classifications in the past,

are not included in the new classifications due to their limited diagnostic sta-

bility, low reliability and weak validity, and are currently considered as a single

disease [156]. Although there are several risk factors for SCZ, the exact cause

has not yet been determined. There is strong evidence of genetic causes. It

is common to think that stressful events play a role in the emergence of the

disease. Although certain schizophrenic brains show structural abnormalities,

particularly in the temporal lobes, this is insufficient to explain the illness

[157]. Initial studies investigating the genetic etiology of SCZ focused on fam-

ily, twin, and adoption studies. With these studies, the role of heredity in the

etiology of SCZ has been confirmed as a risk factor. According to research re-

sults, while genetics has a major role in the etiology of SCZ with a heritability

rate of 81%, it has been stated that the environmental effect is around 11%

[158].

Since SCZ is a chronic disease that affects every aspect of a patient’s life,

the goal of treatment is to reduce or eliminate symptoms, increase the qual-

ity of patient life and improve social adaptation, and reduce the devastating

effects of the disease [159]. Today, with an appropriate treatment method, ap-

proximately 25% of SCZ patients show great improvement and continue their

social lives, and 50% show moderate and good improvement and continue

their social lives relatively independently or with support [160]. First-episode

SCZ patients are typically hospitalized. Despite regular antipsychotic treat-

ment after being treated and discharged, the probability of having a second

attack within the first year is approximately 35%–40% [161]. Apart from the

explanation provided for the symptoms, factors such as age, personality traits,

education level, socioeconomic status, disease severity and type, family and

social environment structure, and the quality of available health services are